苦参碱联合胸腺肽对慢性乙型肝炎患者血清Foxo3a、INF-α、HBV-DNA水平及T细胞亚群的影响  

Effect of matrine combined with thymosin on the levels of serum Foxo3a, INF-α and HBV-DNA and T cell subsets in patients with chronic hepatitis B

作　　者：唐海峰 朱素楠 

机构地区：[1]开封市传染病医院一病区,河南开封475001 [2]开封市传染病医院检验科,河南开封475001

出　　处：《海南医学》2017年第7期1055-1058,共4页Hainan Medical Journal

摘　　要：目的研究苦参碱联合胸腺肽对慢性乙型肝炎(CHB)患者血清叉头盒O类转录因子-3a(Foxo3a)、干扰素-α(INF-α)、乙型肝炎病毒DNA(HBV-DNA)水平及T细胞亚群的影响。方法将2013年4月至2016年4月于我院接受治疗的94例CHB患者,采用随机数表法分为对照组和观察组,每组47例,对照组给予常规治疗+苦参碱注射液治疗,观察组给予常规治疗+苦参碱+胸腺肽注射液治疗,治疗1个月,比较两组患者治疗前后的血清Foxo3a、INF-α、HBV-DNA水平及T细胞亚群的变化。结果治疗后,两组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆红素(TBil)、凝血酶原时间(PT)水平均明显下降,白蛋白明显上升,且观察组治疗后的上述指标改善优于对照组,差异均有统计学意义(P<0.05);观察组患者的HBV-DNA阴转率为51.06%,乙肝病毒e抗体(HBeAb)阳转率为51.06%,乙肝e抗原(HBeAg)阴转率为46.81%,而对照组则分别为23.40%、23.40%、27.66%,两组比较差异均有统计学意义(P<0.05);Foxo3a mRNA表达水平、INF-α、甲胎蛋白(AFP)含量均明显下降(P<0.05),且观察组下降幅度明显高于对照组,差异均有统计学意义(P<0.05);对照组患者的T细胞亚群指标治疗前后无明显变化(P>0.05),而观察组患者治疗后的CD3^+、CD4^+明显上升,CD8+明显下降,CD4^+/CD8^+比值明显上升,与对照组比较差异均有统计学意义(P<0.05);治疗后,两组患者的尿黄、钠减、腹胀、乏力、肝区隐痛症状均明显改善,且观察组改善率高于对照组,差异均有统计学意义(P<0.05);两组患者均未出现明显不良反应。结论苦参碱联合胸腺肽治疗CHB患者可显著降低Foxo3a、INF-α、HBV-DNA水平,改善肝功能,改善临床症状,提高免疫力。Objective To study the effect of matrine combined with thymosin on the levels of serum forkhead box O transcription factor-3a（Foxo3a）, interferon-α（INF-α） and hepatitis B virus DNA（HBV-DNA） and T cell subsets in patients with chronic hepatitis B（CHB）. Methods Ninety-four patients with CHB who were treated in our hospital between April 2013 and April 2016 were randomly divided into the control group and the observation group according to the random number table, with 47 cases in each group. The control group was treated with routine therapy and matrine injection, and the observation group was additionally treated with thymosin injection. After 1 month of treatment, the changes of serum Foxo3 a, INF-α and HBV-DNA levels and T cell subsets before and after treatment were compared between the two groups. Results After treatment, the levels of alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, bilirubin（TBil） and prothrombin time（PT） in both groups were significantly decreased（P〈0.05）, while albumin levels were significantly increased（P〈0.05）. The observation group after treatment improved significantly better than the control group（P〈0.05）. The negative conversion rate of HBV-DNA, positive conversion rate of hepatitis B e antibody（HBe Ab） and negative conversion rate of hepatitis B e antigen（HBe Ag） in the observation group were 51.06%,51.06% and 46.81%, as compared with 23.40%, 23.40% and 27.66% in the control group（P〈0.05）. Levels of Foxo3 a mRNA, INF-α and alpha fetoprotein（AFP） in the two groups were significantly decreased（P〈0.05）, and the decreased amplitude in the observation group was significantly greater than that in the control group（P〈0.05）. In the control group,there was no significant change of T cell subsets before and after treatment（P〈0.05）, while in the observation group,CD3~＋, CD4~＋and CD4~＋/CD8~＋were significantly increased and CD8＋was significantly decreased after treatment, which show

关 键 词：慢性乙型肝炎 苦参碱 胸腺肽 FOXO3A INF-Α T细胞亚群 

分 类 号：R512.62[医药卫生—内科学]